Strollerderby : hospitals

Kids are Suffering in Emergency Rooms Nationwide

JeanneSager — Wed, 20 May 2009 14:00:00 GMT

No one wants to spend a night with their child in the emergency room. But the numbers of kids spending hours in the nation's ERs waiting to be seen by doctors is on the rise.

The problem? It's the economy (duh).

Without health insurance to cover an expensive doctor's visit, parents are turning to the emergency room for their primary care. And they're bringing their kids.

Forty-four percent of children's hospitals in the U.S. have reported a spike in emergency room visits. That's just child-specific hospitals, but numbers are up at other hospitals too (where patients are both adults and kids). This comes on the heels of already growing numbers - even when the economy was steady, the CDC reported a decade-long hike in emergency room visits from 1996 to 2006. Of them, kids made up the largest number, followed by adults over the age of seventy-five.

The chief problem is health insurance, and one in nine kids is estimated to be without it (and of those kids, nine in ten has at least one working parent and is a U.S. citizen). Even folks who qualify for Medicaid often end up carting their kids to the ER because private doctors won't accept it.

But kids are waiting longer and longer periods of time before getting treatment. That's both in the ER (where more visits combined with fewer emergency rooms means longer waits) and out - where parents who worry about the hospital bill are delaying the trip to the hospital. A recent Kaiser survey found at least twenty-seven percent of Americans have actually delayed care because of the cost, And that's what has medical practitioners worried.

Kids' bodies are changing quickly and their immune systems are less developed. They're at greater risk than the average adult, and they need healthcare more desperately than the average adult. Which means parents have to make tough choices - as hard as it may be, and as many sacrifices as it might take, that emergency room visit might be the best option.

Have you suddenly found yourself in an emergency room when you'd never visited one before?

Image: CBS News

OctoMom's Kid - Bite Mark And Black Eye

Brett Singer — Thu, 30 Apr 2009 21:30:00 GMT

This is disturbing.

Social Services paid a visit to Nadya Suleman's home the other day. Surprisingly, this isn't a regular occurrence. They were there to investigate because one of the OctoMom's children, Aidan, had gone to school with a black eye and a bite mark on his back. After a 45 minute interview, investigators left without taking action.

Orange County Child and Family Services and La Habra police did not comment because, you know, things like this are supposed to be confidential. Nadya, however, did an interview with her exclusive outlet, RadarOnline. (Remember when Radar was this hip and cool magazine? Yeah, not anymore.)

In the interview, she managed to make me question her parenting skills even more than I might have previously, which is impressive if you think about it. She tells the interviewer that the social services visit was her fault, because she didn't see the note that Aidan's teacher had pinned to his backpack asking about the injuries. To be fair, I've missed notes as well, but they weren't asking me if my children were participating in after-school cage fights. The scariest line to me is that Aidan's black eye is from "falling down," something he does because he has autism. There's a moment where Nadya says the black eye is from his meltdowns, and "in the process of throwing him... throwing himself on the floor..." I know, it's just a slip, but it's creepy.

As for the bite mark, Nadya says it's from one of his siblings. (To borrow a line from Robin Quivers on the Howard Stern Show, "They're eating each other!")

In the video, you get to see Ms. Suleman attempt to discipline one her kids as he first hits his sibling, then hits the camera. "We're just starting time outs," she says. Seems to be working great. She also tells us that the officials told her they were impressed with how well the family was doing, and "how well-organized her home was." Wow. I don't believe that statement one bit.

I know. It's not fair to criticize parenting skills. Right? Except that she's making these videos on putting them online. Mostly I just feel bad for the kids. There's no way they could possible be getting anything resembing a decent amount of attention from their mother.

Source: AP via Yahoo and RadarOnline

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Octo-Mom Home With All Eight Kids - VIDEO

Brett Singer — Sun, 19 Apr 2009 18:45:00 GMT

Nadya Suleman, the Octo-Mom (do we really need to say that anymore?), has "finally" brought the eighth and final octuplet home to roost. Jonah is his name. (Someone less sensitive than I would make a whale joke here. But I won't.)

RadarOnline has the EXCLUSIVE video of Nadya and the children. The kids are cute. There are a lot of them. She already has six. That makes fourteen.

We know all of this, of course. The question is, do we still care?

Is anyone else surprised at how quickly we seem to have become uninterested in Mme. Suleman? I wonder if whoever signs her up for a TV show is prepared for "Denise Richards – It's Complicated" level ratings. I mean, would you watch an Octo-mom show? Maybe at first, but for how long?

Anyway, here's the video for those who are interested. I sort of am. But I think I've reverted to feeling sorry for the kids, and even slightly sorry for her. Not that I think she didn't create this situation, but, as Hannah wrote, she seems like she might be "crazy in a way that requires compassion and serious psychiatric treatment, not a media campaign, and definitely not a fertility clinic." Well put.

Source: RadarOnline

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Breastfeeding Debates: Just a Tempest in a Sippy Cup?

JeanneSager — Thu, 16 Apr 2009 14:23:00 GMT

Here's the thing about the breast is best debate. Do we really care what another mother does with her boobs?

No, really. You might say you care that she gets the best medical advice, that that precious little baby gets the best start to life. But when your kid and her kid sit side by side in kindergarten, holding hands, is it really going to matter who did what on day thirty-six of that baby's life?

Sometime Babble contributor Lynn Harris turned her often irreverant sense of humor to the oh so serious topic of breastfeeding on NPR this week, and though she treats the subject with all due respect (she is, after all, a mother), she pokes her fun where it's due. The breastfeeding debate, she says, is nothing but "a tempest in a sippy cup."

For MOST women, it isn't about whether or not they think breastfeeding is good for babies, or even whether they WANT to do it. Says Harris:

"Because we don't read the Journal of the American Medical Association to decide whether, or how long, to breast-feed. We consider our bodies: Are we physically able to nurse in the first place? Or are we plagued, as I was with my first child, by plugged ducts and serious mastitis? We consider the child: Did we, luck of the draw, get one who just says no to latching? We consider our workplace: How long is our maternity leave? Where can we pump when we go back?"

And that, my friends, is where the debate needs to take a hike. You want to breastfeed? You made it work? Woohoo! Fabulous! Really. I'm not being facetious here. I'm happy for you that you are able to nourish your child with your breastmilk, that you have got the latch down and find the appropriate place to pump if need be.

Not breastfeeding? Didn't want to? OK, well, that's your choice. Did want to, but couldn't? I'm sorry, is there anything we can do? Other than berating you and telling you you're feeding your child pure evil in liquid form and forcing you onto mega doses of Paxil to handle your postpartum depression caused by feelings of inadequacy?

Here's why everyone needs to read Harris' essay: she puts blame where blame is due. On the crappy advice in hospitals. On the crappy employers who don't give moms appropriate time for pumping. On the family medical leave act's lack of depth and the lack of paid leave time available for new mothers. On the public breastfeeding conundrum, especially for women who are shy and uncomfortable out in the public eye.

"Show me a lactation room at the Qwik Mart, and I'll show you a woman more willing to leave the maternity ward without her care package of free formula," Harris says (see, told you she was a bit irreverant).

Come on moms, let's look at who you're really mad at. It's not each other.

Image/Source: NPR

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Congress: End Amber Alerts by 2010, MicroChip Newborns

JeanneSager — Wed, 01 Apr 2009 15:26:00 GMT

After news that an Amber Alert was cancelled last week when a missing child miraculously walked in her front door, is it any surprise that Congress is taking seriously the toll that helicopter parents are putting on law enforcement with their overreactions?

Congress has put out the call for all newborns born in American hospitals to be microchipped, beginning July 1, 2010. The simple process can be done in the hospital nursery by pediatricians, who will then log the newborn's vital statistics into a national database linked to the FBI for all law enforcement to access. When an officer encounters a child, he will be able to use a scanner to immediately determine if this is the missing child in question.

Funds to outfit the hospitals with the proper equipment, similar to those used in most veterinary offices, and to provide police with scanners will come from President Obama's latest stimulus bill.

Children born before that date are grandfathered - so to speak - but parents will have the option of taking their children to their local hospitals to have the chips implanted just under the skin in a quick outpatient procedure. The chips will be placed near the shoulder for easy access by the scanners, but because of their very small size, there should be no lasting scars on a child's skin.

Will you be taking Junior in?

Image: Zazzle

Gloria Allred Sits On A Booster Seat

Brett Singer — Sat, 28 Mar 2009 14:00:00 GMT

Reading this headline might cause you to think that we're being mean. Before you darn me to heck, though, consider this -- it's true.

W Magazine developed a fascination with Ms. Allred not dissimilar to our own. A key difference is that W Magazine's office is in the same building as Allred's, so staff members at the mono-syllabic-named mag popped in on a recent press conference she had regarding the OctoMom. (Nadya Suleman, perhaps you've heard of her?)

Anyway, among other amusing observations, the editors noticed that the "small and compact" attorney (their words) was seated on an actual booster seat. This one.

What seems odd to me is why Allred wouldn't just get a phone book, or a more grown-up version of a booster seat. Like maybe a pillow. The W editors wonder if "Maybe it's something she picked up from the Suleman kids?" Either that or product placement. Only time will tell.

Image: WMagazine.com

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They Say: Blame Hospitals for Breastfeeding Failures

JeanneSager — Sat, 21 Mar 2009 15:31:00 GMT

Reading this study, I couldn't help but feel a little vindicated. I've always felt like a big fat failure at breastfeeding - despite all my best efforts, I didn't make it very long. And I put a lot of that blame on the misinformation swirling around the maternity ward where I gave birth to my daughter.

Guess what?

A new study says hospitals are largely to blame for the failure of breastfeeding moms in America. And that includes hospitals where attempts are being made to encourage breastfeeding.

The study by the Boston University School of Public Health looked at data on some fifteen hundred women in the nation who had recently given birth. At least seventy percent of first-time moms said they wanted to breastfeed exclusively. Good news, right? Except by the time the babies were a week old, only HALF of the women were exclusively breastfeeding.

Guilty as charged.

Which is why even this article about the study made me angry. One of the chief problems I've found with many maternity wards (not all, but many) is the lack of breastfeeding education for members of the staff. And the same misinformation peddled in hospitals that hurts breastfeeding rates is being pushed out in articles like this one: ie. "some new mothers really are too exhausted to breast feed right away, or they can't produce enough breast milk for their baby's nutritional needs."

No. No. No. No.

I heard this in the hospital after my daughter was born, and I bought it hook, line and sinker. It's one of the main reasons I exhausted myself in the first two weeks of my daughter's life, attempting to breastfeed every two hours, attempting to pump every other hour to increase my milk production because the nurses at the hospital had me convinced I wasn't producing enough. Yes, that meant I was up every hour on the hour for two solid weeks - I was literally tethered to the breast pump.

The problem? Most women DON'T produce milk in the first few days of their child's life. We produce colostrum, the incredibly rich and incredibly thin liquid that's a sort of pre-milk. And that's all the baby needs. As breastfeeding expert Laura Keegan said in a recent piece I wrote about the most common hurdles for new moms right here on Babble, "If you are pumping, be aware that pumping small amounts is not an indicator of a low milk supply."

Colustrum is in every breastfeeding book out there, so why don't nurses working on maternity wards know about it? Although I don't agree that formula is poison, I will say that convincing a mother she isn't making enough . . . so she needs to supplement . . . is poisoning her mind. Her body CAN'T make more, and she's being told she's a failure. Yet, her body is doing exactly what it's supposed to do.

What else is wrong with the above statment? The idea that moms are too exhausted immediately following birth to breastfeed. Yes, we're tired. But after that first feed, so is the baby. In fact, while nurses at my hospital practically tanned the hides of my husband and myself for not waking our daughter every two hours to eat, newborn babies are exhausted too. They just went through the same labor Mom went through. And so sleeping for a few hours is one hundred percent normal. Babies will not starve if they suckle only a few times at the very beginning. And Mom, by the way, may be exhausted. I was. But I've yet to see a mother who isn't on drugs from a C-section or already showing severe signs of postpartum depression who isn't itching to get her hands on that baby in the first twenty-four hours.

So sticking a bottle in the baby's mouth to let his mother sleep is wrong; she should have the chance to make that decision. But so is harping on a breastfeeding mother every few moments - pushing her to breastfeed now, when the baby is sleeping and she could be getting the sleep she missed when you woke her in the middle of the night for a feeding.

There is a movement that's gaining speed in American hospitals, sponsored by UNICEF, that can make all the difference. Baby Friendly Hospitals require all staff - be it the nurses, the doctors, whoever - have up-to-date breastfeeding education. They make lactation consultants available to every mother and allow babies to room-in with their mothers, so she can determine when the baby's hungry and when she wants to attempt feedings.

It takes effort to become Baby Friendly, but if breast is best is ever going to really take hold, misinformation has to stop at the beginning - the place where the baby is born. When you're losing the mothers (like me) who walk in the door with the very best of intentions, the women who already know breast is best and WANT to make it work, you have to step back and realize the machine is broken. It's time to fix it.

Images: BabyFriendlyUSA

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Database of Hospital VBAC Policies Released

Miriam Axel-Lute — Thu, 12 Mar 2009 15:29:00 GMT

If you're planning a VBAC (vaginal birth after cesarean), you'll want to know about the International Cesarean Awareness Network's new database of hopsital VBAC policies (i.e. supportive, ban them, de facto ban because no docs do them...).

While the Our Bodies Ourselves blog notes a few small issues with methodology, it's a darn good start. I've heard of too many people learning too late that the hospital they were planning to go to wouldn't allow them to try VBAC.

Photo by davhor.

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The Dr. Phil And OctoMom Show

Brett Singer — Thu, 12 Mar 2009 01:30:00 GMT

Who needs a publicist? Dr. Phil seems to have decided that he's going to ride the OctoMom Express as far as it will take him.

First, he convinced Nadya to accept help from Angels in Waiting. They may be sketchy, but if Dr. Phil says it's the right thing to do, then that's what

Then he visited the octuplets. Here's a clip:

I like the part where he says, "Oh, of course you see them all the time." Because we need to be reminded of that.

And now he's going to reveal what the arrangement is going to be -- but not until his next show! Because he cares about... ratings.

I understand that Dr. Phil is a TV host and he wants to make money. That's fine. But he pretends that he's being somehow helpful. That's not fine. I mean, he has exactly the same license to practice therapy that I do – none. Nadya Suleman needs actual help, and I don't just mean changing all those diapers. I mean, Angelina Jolie can't adopt all eight of her kids, right?

Source: All over the freakin' Internet

Image: Me and Photoshop

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OctoMom's Second Publicist Quits

Brett Singer — Mon, 09 Mar 2009 03:23:00 GMT

Victor Munoz, the second publicist to take on the OctoMom as a client, has quit. He's also talking smack.

From Us Magazine:

"It just got to be too much," he says. "It's pretty much a free for all over there right now. They are freaking out right now.
"Not to sound arrogant, but those people depended on me for everything," he continues. "You have no idea what I’ve had to do for these people.
"Nadya got real greedy. This woman is nuts," he adds. "This I can say: what ultimately destroyed the business arrangement was personal reasons."

Here's the best part:

Munoz -- who plans to meet with his lawyers Monday to go over the terms of his contract and confidentiality clause -- did not go into further detail.

Oh! Well thank goodness he didn't go into any further detail. And I'm sure we're all thrilled that he's going to see what confidential information he can share.

It was never clear to me why Nadya needed a publicist. Anyone who worked for her should have realized that they were getting involved in a situation that was unlikely to end well. Having worked in PR, I can honestly say that sometimes a client is not worth it. In fact, the only thing that can make a difficult client more bearable is money. In this case, how could there be any money to be had? Suleman's previous flack, Joann Killeen, claimed that she was doing the job gratis, and bailed when she received death threats. Now maybe I'm the crazy one here, but when I hear that about an available job that pays nothing and comes with death threats, my first thought isn't, "Hey! Job opening! Cool!"

I guess Nadya's not the only one who likes the drama.

We now return to... the neverending story...

Source: Us Magazine

Image: Me and Photoshop

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Brett Singer — Thu, 05 Mar 2009 19:00:00 GMT

Here's a new twist on the neverending OctoMom story -- reality.

According to the blog Reality Rounds, discharging preemies, especially 8 of them, is always something that hospitals have to take very seriously. Caring for a premature baby is more difficult than caring for a child who was full-term. Even with a mother who isn't a quasi-celebrity, the babies aren't necessarily just released when the mother decides it's time to go.

This isn't always the case, however. Shannon says that when she arrived to pick up two preemies that she was adopting, no one did any due diligence to make sure she was able to take care of them. "I certainly wasn't visiting them and proving I could diaper and feed them daily, as I didn't know they were alive until the social worker called and said 'come and get your baby.'" Shannon wonders if this would have been the case if the babies had been white.

And Jeanne suspects that the real reason behind the hospital's reticence is legal in nature. "With a high publicity case like this, the hospital lawyers must be frothing at the mouth," she said.

(Note: we all chat by email about this stuff, that's where the quotes are from. In case you were wondering.)

When Nadya tells Dr. Phil that she is worried that the hospital won't release her babies, she should really be concerned with how exactly she is going to care for them. Babies are a tough job. Eight preemies? The mind boggles.

Source: Reality Rounds (thanks to Alice for the tip)

Image: Me and Photoshop

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AUDIO - OctoMom 911 Calls Released

Brett Singer — Thu, 05 Mar 2009 16:02:00 GMT

We already know that Nadya Suleman called 911 when she couldn't find one of her kids. Now we can hear it.

"Help me! My son is missing! I'm going crazy! Where's my son? Where's my son?"

(Visit TMZ to hear the call, or listen to it below.)

It's sad to listen to. Bizarrely fascinating but sad. Most parents will relate to the first call somewhat -- Nadya thinks her five-year-old is missing. The thing is, she loses it completely, saying, "Oh my God, I'm going to kill myself." She is then admonished by the 911 operator to not say something like that in front of her children. "Keep yourself under control." When the kid comes back, says "mommy," it's heartbreaking.

This woman is a mess.

Then comes the second call. One of Nadya's kids calls 911 and hangs up. The 911 operator calls back, talks to the kid, who claims to be in charge of the home, eventually admitting that a babysitter is there. That part is kind of funny. The operator really earns her keep by getting an adult on the phone who says everything is OK.

The common thread between the two calls is chaos. I'm not a fan of chaos. With kids, it happens. With six kids, it probably happens a lot. With fourteen? Do I need to say it?

Forget "reality show." Actual reality has crept into this story.

A commenter over on MomLogic has a theory that I wish I could say I don't take any stock in but it's hard not to at this point: "The movie 'The Changeling' in which Angelina Jolie has scenes where she is frantically beseeching to get her lost son back opened on October 24. Trailers for the movie must have been all over the networks for days. This 911 call came in on Oct 27. Total coincidence, I am sure."

Oy. Vey.

Source: TMZ

Image: Me and Photoshop

OctoMom Video Blog at RadarOnline

OctoMom Rejects Angels In Waiting Offer

OctoMom Says Denis Beaudoin is Not OctoDad

Gloria Allred Offers To Help OctoMom

OctoMom Says No Dating For Her

OctoMom Loathes Being Pregnant

UPDATE! Octo-Mom Alert! Police Visits and a Child Services Investigation

Octo-Mom Birth Video to Fetch a Cool Million?

Hospital Hangs on to Children's Bodies for Two Years

JeanneSager — Tue, 20 Jan 2009 21:40:00 GMT

It's almost the exact opposite of the stillborn baby thrown in a New Jersey hospital's trash - and just as horrifying.

When a British mother suffered her second miscarriage, she went to the hospital to see if she could arrange a funeral for little Jonah.

He had already been cremated, the hospital told her. But her first son, miscarried two years ago at twelve weeks, was still in the hospital, they said. Would she like him?

Leanne McCabe had been told baby Ty was cremated shortly after her miscarriage because of a British law that requires babies stillborn before twenty-four weeks be "disposed of" by the hospital, usually via cremation. Why she never returned for his cremains is unclear (although it IS clear she wasn't aware that his body was still lying in a mortuary two years later).

McCabe's discovery has since led to the hospital's admission that hers isn't the only stillborn baby awaiting his parents' final wishes to be carried out. Two more suffered what hospital administration dubbed a "delay."

I know it's coincidence that this story came up just over a week after the missing New Jersey baby tale. It's hardly a pandemic. But what do these stories say about how the world treats stillborn and miscarried babies? Do these hospital officials think they matter less or that the outrage would be diminished because the children never actually breathed in the real world?

Moms who suffer through miscarriage and stillbirth already suffer with the misperception that their grief should somehow be less because, well, "at least you didn't have a child and lose it." No, in many ways they didn't have a child - they had a baby who they never got to enjoy, but that doesn't diminish their feelings of love or the depth of their loss. And their children all deserve the same amount of respect in the end.

Image/Source: BBC

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Move Over Angie's List: It's the Birth Survey

Miriam Axel-Lute — Fri, 09 Jan 2009 17:30:00 GMT

The Internet is a wonderful thing for making our opinions known: We can rate our professors, our Amazon purchases, our contractors, and our favorite blog posts (hint, cough). Why not our midwives and doctors and hospitals?

After a pilot in New York City, the Coalition for the Improvement of Maternity Services has launched The Birth Survey to collect detailed information about mothers' experiences with their pre-natal, labor and delivery, and post-partum care. If you've given birth in the last three years, I strongly urge you to go fill it out. The sooner they get a volume of responses, the sooner other parents can get meaningful information on the options in their area. (NYC parents can already view the pilot data here.)

The survey is anonymous, and takes about 20 minutes (longer probably if you're ranking more than one care giver, which you have the option to do). It gives you almost entirely questions that are relevant to you based on your previous answers, which makes it much more pleasant to fill out than many surveys, especially on something that can go as many different ways as birth.

The questions focus on issues that feed into CIMS's 10 Steps to Mother-Friendly Childbirth, especially things like how much support and information care providers gave and how well they listened and respected parents' wishes, as well as breastfeeding support provided and what sorts of procedures were done during labor and delivery and what rationales were given for them.

I also took the demo survey to see what kind of questions they asked about hospital births, and though it's clear they are concerned about high c-section rates, for example, I think they did a good job of being non-judgmental and focused on the mother's experience and assessment. And in case the survey brings up bad memories for anyone who had even half as miserable an experience as Catherine Skol (the Chicago mom suing her abusive OB), they also provide links to networks of counselors experienced in helping with birth trauma at the end of the survey.

If you've always wanted to officially record your displeasure with or your gratitude for (or ambivalence about) your birth attendants, now's the time!

Photo by peretzpup.

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Mother Sues OB Who Said She "Deserved Pain"—And Gave It to Her

Miriam Axel-Lute — Fri, 02 Jan 2009 22:00:00 GMT

Catherine Skol, former Chicago cop and mother of five, is suing her OB for abusive treatment during the birth of her fifth, nine months ago. If you've heard of the case, and the arguments that she's "just suing over rudeness" and should quit it because she's going to make malpractice rates go up, I suggest you go here, and read the details of the allegations.

I don't suggest you read it if you are pregnant and about to head into a hospital delivery however.

According to the suit, defendent Scott Pierce, who was filling in for the Catherine Skol's primary OB, was so incensed that she hadn't called him before heading to the hospital (an instruction her main OB had never given her) that he decided she "deserved" pain, refused an epidural, put her in intentionally painful positions, insisted she push before she was sufficiently dilated, kept telling her she was going to hemorrhage, wouldn't give her enough anesthesia before stitching her up and told her husband to "hold her down" instead, and talked loudly and crudely on a cell phone about an abortion in the room. There's more. It's truly astounding, in a nauseating kind of way.

(Confidential to "Linka" who called Skol a wimp for complaining about not getting her pain meds: I'm no fan of routine epidurals and had my kid with none, but I would never claim to know out of context when one was appropriate. And I'd like to see you get stitches for a severe laceration on your vulva without anesthesia, not mention all that other crap.)

As much as I've heard plenty of horror stories about OBs and their attitudes, I have to say that this is a category all its own, and sounds to me like the sort of extremely aggressive behavior that arises when people are on something illegal or are having, shall we say, certain brain chemical imbalances. Not that there aren't people out there who are just that awful, but they don't generally keep a job like doctor very long.

In fact, his behavior bothers me less than the commenters who say that because she and the baby are physically healthy, she should shut up and deal. Aside from being cruel, the behavior described was dangerous. If it's anything like she described, he should have his license revoked. People sue all the time for doctors failing to prevent problems they couldn't have prevented—that's one of the reasons our c-section rate (and malpractice insurance) is so high. Here's a case where the doctor was actually in the wrong rather than just getting the blame for a tragedy. This is what lawsuits are for.

Photo by Bloomsberries.

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U.S. Birth Centers in Danger of Closing

Miriam Axel-Lute — Thu, 18 Dec 2008 21:00:00 GMT

Everyone likes a best of both worlds solution, right? For many pregnant women, birth centers provide just that. For low-risk pregnancies, they are a comfortable, calm, non-hospital atmosphere in which to give birth. They often have pools, and kitchens for family members to cook in. They don't separate mother and baby after birth, but check vitals right there. And yet, for those uncomfortable with birthing at home, there are also a staffed and equipped medical facility, usually quite near a hospital and with established transfer protocols in place. They are often crucial in rural areas where hospitals are few and far between.

And yet, after 20 years, the federal Medicaid agency has all of a sudden begun to refuse to pay for them. (Why? Do they prefer to pay tons more for a hospital birth?) The agency claims there is nothing specifically in any legislation saying that it's a covered cost. (Ah, I see. Bureaucracy strikes again.)

This is not merely a case of the poor getting screwed either notes the American Association of Birth Centers. Other payers follow Medicaid's example, they say. Basically, if the law isn't changed, pronto, freestanding birth centers will be fighting for their financial lives. Many are already suffering from refused payments.

There is a chance to clarify the law when the SCHIP bill passes, but it has to be done before the Christmass recess, so AABC is asking everyone to call their congresspeople and let them know that this is in fact important—a no-brainer even (but perhaps you oughtn't to use that phrase).

Photo from Alma Midwifery.

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Rural Hospitals Dropping Maternity Care

Amy Kuras — Mon, 24 Nov 2008 22:06:00 GMT

Living in a pretty good-size city and having good health insurance, I pretty much had my pick of hospitals to deliver my kids. The one we chose had opened a new wing with an incredibly nice mother-baby unit shortly before I delivered my daughter – and went all private rooms in the intervening three years before I gave birth to my son. Faaancy.

But in rural areas, some hospitals are dropping childbirth care altogether. While it’s usually a pretty big profit center for hospitals, according to this article from Northeast Georgia, some small hospitals are finding the expense of providing obstetrics exceeds what they could make from the small number of patients they see.

Kevin Bloye, spokesman for the Georgia Hospital Association, said, "It’s a tough time to be a rural hospital. The important factor is payer mix. In rural areas especially, the base of insured patients is shrinking. You need to have enough insured patients to offset the cost of treating Medicaid and uninsured patients."

That’s right, the healthcare crisis rears its ugly head again.

It’s not that pregnant women will have nowhere to go – two fairly nearby hospitals just opened new obstetrics units – but for people who maybe wanted a smaller, closer to home experience, that’s got to be a blow. And not only that, but they just announced this month that they’d stop delivering babies on Dec. 9. I was pretty amped up on hormones near the end, and if someone announced I would have to go elsewhere very close to the end of my pregnancy I would have lost it. Waiting out a due date is hard enough without wondering if your hospital will still be open.

Hey Grandpa’s Knocked Up! Hospital Tells 71-Year Old He’s Pregnant

SunnyChanel — Sun, 28 Sep 2008 00:19:00 GMT

When a woman of childbearing age starts to have stomach discomfort, many jump to the conclusion that “hmm, maybe you’re pregnant!”. But if you are a 71-year-old grandfather, that result would generally not be the go-to diagnosis.

When Oregon resident John Grady Pippen was discharged from the hospital this week, going there for agonizing abdominal pain, his paperwork said “Based on your visit today, we know you are pregnant.". Congratulations grandpa! But it turns out that Mr. Pippen isn’t expecting, the hospital administer made an “errant keystoke” and the wrong discharge instructions were printed out.

13 Newborn Deaths, One Hospital, Same Day

Jen Chaney — Tue, 23 Sep 2008 12:02:00 GMT

Yeah, you read that headline correctly. Apparently that unlucky number of recently born babies died in the same day at a hospital in Turkey and officials there are attempting to investigate the cause.

BBC.com reports that all the children were premature and that an infection may have been at least a partial cause. But here's the part of the story that shocked me.

A doctor at the hospital said that seeing 13 deaths in a 24-hour period was unusual because "under normal conditions, we lose five or six babies in three days and less than 20 in a month." Um, what? That's 1.6 to 2 babies per day, and that's considered normal? Granted, the infant mortality rate in Turkey is much higher than it is in the U.S., but when you break down the numbers to that level, the impact of those losses really hits home.

It's unfortunate that even at a hospital, those infants couldn't be saved. Hopefully the cause in this case can be determined definitively and future multiple deaths like these can be prevented.

Image: Todays Zaman

Mom Gives Birth in Parking Lot After Hospital Sends Her Home

Miriam Axel-Lute — Thu, 18 Sep 2008 19:15:00 GMT

Sometimes it seems that the only out-of-hospital births hospitals support are unplanned ones. How many times have we heard this story? "You're not in labor. Go home." And the parents dutifully do, and end up giving birth in cars on their way back with only police officers or taxi drivers for help.

Mistakes do happen. Labor is unpredictable. Nervous parents do show up way too soon. In this case from the U.K., though, the mother, Lynn Gillespie, had had two kids before, and so when she says she knew she was in labor you want to believe her. (Of course the Doncaster Royal Infirmary—pictured—did convince her to go home, so I guess she wasn't sure enough to fight about it.)

Overall, this strikes me as yet another risk of giving birth in a place where your time there is limited and you can't just hang out and see what's coming (i.e. a hospital). I sure can't imagine having had to make a "When do we go to the hospital?" decision in the middle of my labor.

This time it has a happy ending at least. Gillespie ended up giving birth to a healthy daughter in the parking lot of a police station. The baby arrived just as the paramedics did.

The hopsital, meanwhile, reports that they are sorry she was disappointed with the care they provided. Um, what care would that be?

Just to Totally Freak You Out – Little Patients = Big Mistakes.

SunnyChanel — Tue, 16 Sep 2008 16:45:00 GMT

You know what I hate? Hospitals. The only time going to one is a joyful occasion is when your there to have a baby. All other times you’re there is because something is wrong or your trying to keep something from going wrong. When you have kids, their health is of the utmost importance and in the forefront of your mind, so just to totally freak you out, the New York Times published a piece called Small Patients, Big Consequences in Medical Errors. Yeah, like you don’t have enough to worry about.

Medical mistakes, which can be pretty common with us grown ups, when they occur with kids they have “more serious consequences”. They site the ultra scary example of the actor Dennis Quaid’s newborn twins getting 1,000 times the amount of heparin, the blood thinner, than they were supposed to get. They survived but less famous offspring have died from the same mistake. Studies have found that there are issues with medications in 11% of children in the hospital. A big issue is the dosage amounts, which must be calculated from adult doses to include the child’s weight and occasionally height, “it’s easy to misplace a decimal point”. Plus “children are also the victims of diagnostic errors, incorrect procedures or tests, infections and injuries.” And misdiagnosis is also common occurrence with meningitis, appendicitis and broken arms the most frequent errors.

Like we didn’t have enough to worry about right? So keep those kids healthy and out of the hospital! But if you do find yourself there here are 11 tips from the New York Times to keep in mind when in the there.

ID BRACELETS If your child is in the hospital, make sure the identification bracelet is worn at all times.

HYGIENE Ask all health care providers to wash their hands before approaching your child.

INFORMATION Before a procedure, ask the surgery team’s members if they know exactly what the procedure is.

KNOWLEDGE Schedule a time every day to review with the physician and nurses the medications your child is taking and any other information about his care.

AWARENESS Keep an eye on catheters and incisions, looking for redness and swelling.

ASK QUESTIONS If your child is very sick, make sure a pediatric specialist is involved, and ask whether your child should be moved to a children’s hospital.

TALK ABOUT IT Express your concerns about a missed diagnosis.

BE PREPARED Carry a list of the medications your child is taking and remind doctors about any allergies your child has.

DOUBLE-CHECK Understand why medications are being ordered, and don’t be afraid to ask the doctor to double-check that he used your child’s correct weight and height in calculating the dose.

MEDICINES Familiarize yourself with the medications so that you can recognize if your child is given the wrong pill or liquid. Ask about potential complications and whom to contact if your child has a reaction.

VIGILANCE Be especially watchful if your child is taking multiple medications or is on high-risk medications like chemotherapy drugs, insulin or heparin, or if your child has a compromised immune or organ function.

For the entire article click here.

Couple Sues After Failed Vasectomy

Hannah Tennant-Moore — Thu, 11 Sep 2008 00:04:00 GMT

What would your first assumption be if your wife got pregnant after you’d had a vasectomy? Would you suspect her of being unfaithful—or your sperm of outsmarting your sterilization surgery?

Well, unless your marriage is on the rocks or you’re swingers (and, hey, I don’t judge!), the latter is the more likely. At least 1 percent of vasectomies fail to prevent pregnancy—just as condoms break and women on the pill get pregnant.

Mindy and Brady Hill of Arkansas found out what it was like to be that one percent (as, presumably, have thousands of other couples), and they didn’t like it one bit. They claim that doctors suggested that Mindy had been unfaithful, which put stress on their marriage. After Mindy miscarried, a paternity test showed that there was a 99.999 percent chance that the baby was Brady’s. No doubt this whole ordeal was highly stressful and unpleasant. Still, one would hope that Brady trusted Mindy enough that a paternity test wasn’t necessary to make him believe that the baby was his. But, of course, a paternity test will come in handy in court.

Mindy and Brady are suing for negligence and defamation. Should they win?

Photo: Shaadi Times

Should 21-Year-Olds Get Vasectomies?

Only 43% of British Moms Offered Home Birth! Outrage!

Miriam Axel-Lute — Fri, 05 Sep 2008 20:55:00 GMT

Here in the states, we know things are a little different across the pond. British nannies have a certain something, their weather lacks a certain something, and there's that whole royalty business.

But sometimes we forget just how deep the differences can go. Take maternity care. In fact, in order to avoid a rose-colored-glasses look, take what bugs Brits about their maternity care, as described in a government-sponsored survey, and reported under headlines like "Maternity Nightmares!"

The top concerns, according to one TV station that has done a recent follow up, are:

"43% of women were not offered a home birth
23% said they were underfed in hospital
36% were not offered antenatal classes
18% said toilets and bathrooms on wards were not clean"

Well now. Certainly dirty bathrooms and not feeding new mothers enough is unacceptable. Sounds like there's some serious funding and staffing issues at NHS.

But to American eyes that top item feels a little like hearing someone complaining about the freshness and flavor of their food while you're starving. Natural childbirth and midwifery advocates here would be doing a ~~little~~ major happy dance if anywhere near 57 percent of pregnant American women were offered a home birth. (Or, you know, even if fully trained home birth midwives were no longer treated as criminals.)

Even though the survey found only about 3 percent of British moms actually did give birth at home, even the mainstream British media clearly thinks having the choice presented to everyone is important. How strangely refreshing. Perhaps the AMA (which is trying to make home birth illegal) is overdue for a British invasion.

BirthChoice logo used with permission.

Is It Wrong for Hospitals to Give Formula to Breastfeeders?

Jen Chaney — Wed, 03 Sep 2008 13:58:00 GMT

It happened to me, and maybe it happened to you. As I prepared to leave the hospital with my newborn, nurses handed me -- a still recuperating mom clearly attempting to breastfeed -- a goody bag that contained free samples of infant formula. A button sporting the Similac teddy bear even hung from the bag's handles.

According to new information published in the Archives of Pediatric & Adolescent Medicine, and mentioned in this Chicago Tribune story, my hospital isn't the only one. After surveying close to 1,300 medical facilities on the East Coast, researchers found that 94 percent of them disseminate formula samples even while encouraging mothers to nurse.

Some say the samples are nothing more than freebies intended to be used as back-up if breastfeeding issues arise. Others insist they send a mixed message and imply that it's okay to bail on the whole boob thing. Or, to put it in the extreme terms attributed to the chairwoman of the Chicago Area Breastfeeding Coalition: "Handing bags of free formula, even formula advertising, is like handing out Big Macs on the cardiac floor."

In the words of Robert Downey, Jr. in "Tropic Thunder": "Pump your brakes, kid." I understand why the formula and all the nursing advocacy seem to be at odds with each other. But the Big Mac analogy is a little ridiculous. Eating a greasy, fat-laden burger after a heart attack is taking a serious health risk. Giving a baby a free sample of formula may not be as solid a choice as giving him breastmilk, but it's not going to give him high cholesterol and put him back in the E.R.

I'm not sure that it's a good idea to give out those samples. I think on more than one occasion, I may have used them as a crutch. At the same time, the hospital also loaned me a highgrade breast pump (yes, for a fee, but still) and made sure I had all the information I needed about lactation consultants, which I also took advantage of. In the end, while there may be a mixed message inherent in all this, I think we mothers make our own choices about how to nurture our children. If we're super-committed to breastfeeding and aren't having major problems with it, all we have to do is chuck the samples, or pass them on to another mom who might use them. Voila. We don't have them anymore. Case closed. And if we're struggling, well, at least we have the option to try them on our fifth consecutive night with sore nipples and no sleep.

Did anyone else get free formula samples in the hospital? I'm curious to know how accurate those survey numbers are. And also, while you're up, can you get me a burger? All this talk of Big Macs is making me hungry.

Children opposed to healthcare (Onion Video)

Brett Singer — Wed, 20 Aug 2008 17:00:00 GMT

You know, so often with issues that face our society, we fail to ask: what about the children?

Healthcare is a hot-button issue in the upcoming Presidential election. The Onion presents reports on a study that shows that kids, when asked if they would like to go to the doctor more often, respond "NOOOO!!!!!" in overwhelming numbers. "The vast majority of children," they say, "do not want healthcare."

This is, of course, a joke. But it rings true, especially the closing line of the video.